114-488: Gulf War syndrome ( GWS ) also known as Gulf War Illness or Chronic Multi-symptom Illness , is a chronic and multi-symptomatic disorder affecting military veterans of both sides of the Gulf War (1990–1991). A wide range of acute and chronic symptoms have been linked to it, including fatigue , muscle pain , cognitive problems, insomnia, rashes and diarrhea . Approximately 250,000 of the 697,000 U.S. veterans who served in
228-627: A causal link between GWI and exposure to low levels of sarin, which was released into the air by coalition bombing of Iraqi chemical weapons facilities. Significantly, the study found an increased incidence of GWI not only among veterans who recounted hearing nerve agent alarms, but also among veterans with the RR or QR (as opposed to the QQ) forms of the PON1 gene, which produces an enzyme that deactivates organophosphates (including sarin) through hydrolysis . By contrast, GWI
342-412: A methodological issue in research involving interviews or questionnaires . In this case, it could lead to misclassification of various types of exposure . Recall bias is of particular concern in retrospective studies that use a case-control design to investigate the etiology of a disease or psychiatric condition. For example, in studies of risk factors for breast cancer , women who have had
456-546: A Kuwaiti armored battalion, 35th Armoured Brigade , deployed them against the Iraqi attack and conducted a robust defense at the Battle of the Bridges near Al Jahra , west of Kuwait City. Kuwaiti aircraft scrambled to meet the invading force, but approximately 20% were lost or captured. A few combat sorties were flown against Iraqi ground forces. The main Iraqi thrust into Kuwait City
570-409: A VA federal advisory committee mandated by Congress in legislation enacted in 1998, found that pre-2005 studies suggested the veterans' illnesses are neurological and apparently are linked to exposure to neurotoxins , such as the nerve gas sarin, the anti-nerve gas drug pyridostigmine bromide, and pesticides that affect the nervous system. The RAC concluded in 2004 that, "research studies conducted since
684-512: A case-by-case basis. A 2018 study stated that "the number of Gulf War veterans who developed the Gulf War syndrome following exposure to high quantities of DU has risen to about one-third of the 800,000 U.S. forces deployed," with 25,000 of those having had a premature death. A 2021 study by a team at the University of Portsmouth tested urine samples of 154 US veterans, reporting that no soldiers with
798-412: A consequence of Gulf War deployment. However, a 2006 review of several studies of international coalition veterans' children found no strong or consistent evidence of an increase in birth defects, finding a modest increase in birth defects that was within the range of the general population, in addition to being unable to exclude recall bias as an explanation for the results. A 2008 report stated that "it
912-454: A form of economic warfare, which it claimed was aggravated by Kuwait slant-drilling across the border into Iraq's Rumaila oil field . According to oil workers in the area, Iraq's slant drilling claim was fabricated, as "oil flows easily from the Rumaila field without any need for these techniques." At the same time, Saddam looked for closer ties with those Arab states that had supported Iraq in
1026-547: A local armed resistance movement following the Iraqi occupation of Kuwait. The Kuwaiti resistance's [ ar ] casualty rate far exceeded that of the coalition military forces and Western hostages. The resistance predominantly consisted of ordinary citizens who lacked any form of training and supervision. A key element of US political, military and energy economic planning occurred in early 1984. The Iran–Iraq war had been going on for five years by that time and both sides sustained significant casualties, reaching into
1140-571: A part of the Ottoman Empire 's province of Basra , something that Iraq claimed made Kuwait rightful Iraqi territory. Kuwait's ruling dynasty, the al-Sabah family , had concluded a protectorate agreement in 1899 that assigned responsibility for Kuwait's foreign affairs to the United Kingdom. The UK drew the border between Kuwait and Iraq in 1922, making Iraq almost entirely landlocked. Kuwait rejected Iraqi attempts to secure further provisions in
1254-564: A possible cause of Gulf War syndrome. A 2008 review by the U.S. Department of Veterans Affairs found no association between DU exposure and multisymptom illness, concluding that "exposure to DU munitions is not likely a primary cause of Gulf War illness". There is some evidence that long-term exposure to high doses of DU can cause other health problems that are unrelated to GWS. Since 2011, US combat veterans may claim disability compensation for health problems related to exposure to depleted uranium. The Veterans Administration decides these claims on
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#17329054393601368-599: A request for Kuwait to lease Iraq Umm Qasr was rejected. Saudi-backed development projects were hampered by Iraq's large debts, even with the demobilization of 200,000 soldiers. Iraq also looked to increase arms production so as to become an exporter, although the success of these projects was also restrained by Iraq's obligations; in Iraq, resentment to OPEC's controls mounted. Iraq's relations with its Arab neighbors, particularly Egypt, were degraded by mounting violence in Iraq against expatriate groups, who were well-employed during
1482-448: A significant portion of the soldiers deployed to the Gulf War have experienced troubling constellations of symptoms that are difficult to categorize," said committee chair Stephen L. Hauser, professor and chair, department of neurology, University of California, San Francisco (UCSF). Unfortunately, symptoms that cannot be easily quantified are sometimes incorrectly dismissed as insignificant and receive inadequate attention and funding by
1596-490: A strong air defense. Iraqi commandos infiltrated the Kuwaiti border first to prepare for the major units, which began the attack at midnight. The Iraqi attack had two prongs, with the primary attack force driving south straight for Kuwait City down the main highway, and a supporting attack force entering Kuwait farther west, but then turning and driving east, cutting off Kuwait City from the country's southern half. The commander of
1710-620: A successful counteroffensive ( Operation Undeniable Victory ), and the US increased its support for Iraq to prevent Iran from forcing a surrender. In a US bid to open full diplomatic relations with Iraq, the country was removed from the US list of State Sponsors of Terrorism. Ostensibly, this was because of improvement in the regime's record, although former US Assistant Defense Secretary Noel Koch later stated: "No one had any doubts about [the Iraqis'] continued involvement in terrorism ... The real reason
1824-675: A total Iraqi pullout from Kuwait, without any linkage to other Middle Eastern problems, accepting the British view that any concessions would strengthen Iraqi influence in the region for years to come. On 12 August 1990, Saddam "propose[d] that all cases of occupation, and those cases that have been portrayed as occupation, in the region, be resolved simultaneously". Specifically, he called for Israel to withdraw from occupied territories in Palestine, Syria, and Lebanon, Syria to withdraw from Lebanon, and "mutual withdrawals by Iraq and Iran and arrangement for
1938-422: A war zone. Military personnel also had to cope with swarms of insects, requiring the widespread use of pesticides. High-powered microwaves were used to disrupt Iraqi communications, and though it is unknown whether this might have contributed to the syndrome, research has suggested that safety limits for electromagnetic radiation are too lenient. The Research Advisory Committee on Gulf War Veterans' Illnesses (RAC),
2052-445: A year, that Kuwait was still using the Rumaila oil field, and that loans made by the UAE and Kuwait could not be considered debts to its "Arab brothers". He threatened force against Kuwait and the UAE, saying: "The policies of some Arab rulers are American ... They are inspired by America to undermine Arab interests and security." The US sent aerial refuelling planes and combat ships to
2166-496: Is difficult to draw firm conclusions related to birth defects and pregnancy outcomes in Gulf War veterans", observing that while there have been "significant, but modest, excess rates of birth defects in children of Gulf War veterans", the "overall rates are still within the normal range found in the general population". The same report called for more research on the issue. Persian Gulf War veterans have been identified to have an increased risk of multiple sclerosis . A 2017 study by
2280-440: Is inconsistent or limited in important ways." Iraq had loaded anthrax, botulinum toxin, and aflatoxin into missiles and artillery shells in preparing for the Gulf War and these munitions were deployed to four locations in Iraq. During Operation Desert Storm, 41% of U.S. combat soldiers and 75% of UK combat soldiers were vaccinated against anthrax. Reactions included local skin irritation, some lasting for weeks or months. While
2394-555: Is linked to exposure to sub-lethal amounts of organophosphates, particularly sarin . Exposure to pesticides containing other organophosphates and exposure to pills containing pyridostigmine bromide , used as a pretreatment to protect against nerve agent effects, has been found to be associated with the neurological effects seen in Persian Gulf War syndrome. Other potential causes that have been investigated are cyclosarin and emissions from oil well fires , but their relationships to
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#17329054393602508-587: Is more specific and may be more applicable for research settings, while the CDC case definition is more broad and may be more applicable for clinical settings. Medical ailments associated with service in the 1990–1991 Gulf War have been recognized by both the U.S. Department of Defense and the U.S. Department of Veterans Affairs . Before 1998, the terms Gulf War syndrome, Gulf War veterans' illness, unexplained illness , and undiagnosed illness were used interchangeably to describe chronic unexplained symptoms in veterans of
2622-420: Is more strongly associated with Gulf War illness than more limited use. Pesticide use during the Gulf War has also been associated with neurocognitive deficits and neuroendocrine alterations in Gulf War veterans in clinical studies conducted following the end of the war. The 2008 report concluded that "all available sources of evidence combine to support a consistent and compelling case that pesticide use during
2736-401: Is not consistently linked to having or not having symptoms. The lack of data on veterans' pre-deployment and immediate post-deployment health status and lack of measurement and monitoring of the various substances to which veterans may have been exposed make it difficult—and in many cases impossible—to reconstruct what happened to service members during their deployments nearly 20 years after
2850-746: The 2003 invasion of Iraq and the subsequent Iraq War). Some authors have called it the Second Gulf War to distinguish it from the Iran–Iraq War . Liberation of Kuwait ( Arabic : تحرير الكويت ) ( taḥrīr al-kuwayt ) is the term used by Kuwait and most of the coalition's Arab states, including Saudi Arabia, Bahrain, Egypt, and the United Arab Emirates . Terms in other languages include French : la Guerre du Golfe and Guerre du Koweït ( War of Kuwait ); German : Golfkrieg ( Gulf War ) and Zweiter Golfkrieg ( Second Gulf War ). Most of
2964-435: The Battle of Medina Ridge , the Battle of Norfolk , and the Battle of 73 Easting . The war is also known under other names, such as the Second Gulf War (not to be confused with the 2003 Iraq War , also referred to as such ), Persian Gulf War , Kuwait War , First Iraq War , or Iraq War before the term "Iraq War" became identified with the 2003 Iraq War (also known in the US as " Operation Iraqi Freedom "). The war
3078-452: The Food and Drug Administration (FDA) approved the vaccine, it never went through large-scale clinical trials. While recent studies have demonstrated the vaccine is highly reactogenic , there is no clear evidence or epidemiological studies on Gulf War veterans linking the vaccine to Gulf War illness. Combining this with the lack of symptoms from current deployments of individuals who have received
3192-601: The Iraq–Saudi Arabia border . The conflict marked the introduction of live news broadcasts from the front lines of the battle, principally by the American network CNN . It has also earned the nickname Video Game War , after the daily broadcast of images from cameras onboard American military aircraft during Operation Desert Storm. The Gulf War has also gained fame for some of the largest tank battles in American military history :
3306-511: The Israeli-occupied territories , where riots had resulted in Palestinian deaths, was vetoed by the US, making Iraq deeply skeptical of US foreign policy aims in the region, combined with the reliance of the US on Middle Eastern energy reserves. In early July 1990, Iraq complained about Kuwait's behavior, such as not respecting their quota, and openly threatened to take military action. On
3420-632: The Kuwait Air Force was around 2,200 Kuwaiti personnel, with 80 fixed-wing aircraft and 40 helicopters. In spite of Iraqi saber rattling , Kuwait did not mobilize its force; the army had been stood-down on 19 July, and during the Iraqi invasion many Kuwaiti military personnel were on leave. By 1988, at the end of the Iran–Iraq war, the Iraqi Army was the world's fourth largest army, consisting of 955,000 standing soldiers and 650,000 paramilitary forces in
3534-511: The National Academy of Sciences Institute of Medicine (IOM)—contracted by the U.S. Department of Veterans Affairs for the task—released a report concluding that the creation of a new case definition for chronic multisymptom illness in Gulf War veterans was not possible because of insufficient evidence in published studies regarding its onset, duration, severity, frequency of symptoms, exclusionary criteria, and laboratory findings. Instead,
Gulf War syndrome - Misplaced Pages Continue
3648-565: The United Kingdom , and Egypt as the largest lead-up contributors, in that order. United Nations Security Council Resolution 678 , adopted on 29 November 1990, gave Iraq an ultimatum, expiring on 15 January 1991, to implement Resolution 660 and withdraw from Kuwait, with member-states empowered to use "all necessary means" to force Iraq's compliance. Initial efforts to dislodge the Iraqis from Kuwait began with aerial and naval bombardment of Iraq on 17 January, which continued for five weeks. As
3762-454: The 1990–91 Gulf War theatre of operations ("onset") and must have been present in the year before interview ("duration"). Participants were excluded if they had a diagnosis of or were being treated for any of several conditions that might otherwise explain their symptoms ("exclusionary criteria"), including cancer, diabetes, heart disease, chronic infectious disease, lupus, multiple sclerosis, stroke, or any serious psychiatric condition. Applying
3876-518: The 1991 Gulf War. The term chronic multisymptom illness (CMI) was first used following publication of a 1998 study describing chronic unexplained symptoms in Air Force veterans of the 1991 Gulf War. In a 2014 report contracted by the U.S. Department of Veterans Affairs, the National Academy of Sciences Institute of Medicine recommended the use the term Gulf War illness rather than chronic multisymptom illness . Since that time, relevant publications by
3990-676: The 23rd, the CIA reported that Iraq had moved 30,000 troops to the Iraq-Kuwait border, and the US naval fleet in the Persian Gulf was placed on alert. Saddam believed an anti-Iraq conspiracy was developing – Kuwait had begun talks with Iran, and Iraq's rival Syria had arranged a visit to Egypt. On 15 July 1990, Saddam's government laid out its combined objections to the Arab League , including that policy moves were costing Iraq $ 1 billion
4104-711: The Emir's youngest brother. Within 12 hours, most resistance had ended within Kuwait, and the royal family had fled, allowing Iraq to control most of Kuwait. After two days of intense combat, most of the Kuwaiti military were either overrun by the Iraqi Republican Guard , or had escaped to Saudi Arabia. The Emir and key ministers fled south along the highway for refuge in Saudi Arabia. Iraqi ground forces consolidated their control of Kuwait City, then headed south and redeployed along
4218-805: The GW and other conflicts have been called "toxic wounds" by veterans. This type of injury requires further study and concentrated treatment research efforts that may also benefit other occupational groups with similar exposure-related illnesses." Low-level exposure to nerve agents has been suggested as the cause of GWI. In 1991, Chemical detection units from Czechoslovakia, France, and Britain confirmed chemical agents. French detection units detected chemical agents. Both Czech and French forces reported detections immediately to U.S. forces. U.S. forces detected, confirmed, and reported chemical agents; and U.S. soldiers were awarded medals for detecting chemical agents. The Riegle Report said that chemical alarms went off 18,000 times during
4332-411: The Gulf War also experienced acute and chronic symptoms associated with Gulf War syndrome. A 2011 study in the U.S. Army Medical Department Journal reported Iraqi veterans of the Gulf War had a higher prevalence of somatic disorders as compared to Iraqi civilians, with risk greater in troops stationed in Kuwait. In comparison to Allied troops, health symptoms were similar amongst Iraqi veterans: Many of
4446-481: The Gulf War have enduring chronic multi-symptom illness, a condition with serious consequences. From 1995 to 2005, the health of combat veterans worsened in comparison with nondeployed veterans, with the onset of more new chronic diseases, functional impairment, repeated clinic visits and hospitalizations, myalgic encephalomyelitis/chronic fatigue syndrome -like illness, post-traumatic stress disorder , and greater persistence of adverse health incidents. Gulf War illness
4560-619: The Gulf War illness complex could result from interplay between both biological and psychological factors." The 2008 VA report on Gulf War illness and the Health of Gulf War Veterans suggested a possible link between GWI and chronic , nonspecific inflammation of the central nervous system that cause pain, fatigue and memory issues, possibly due to pathologically persistent increases in cytokines and suggested further research be conducted on this issue. Clinical diagnosis of Gulf War illness has been complicated by multiple case definitions. In 2014,
4674-505: The Gulf War is causally associated with Gulf War illness." According to the VA's 2008 RAC report, "For several Gulf War exposures, an association with Gulf War illness cannot be ruled out. These include low-level exposure to nerve agents, close proximity to oil well fires, receipt of multiple vaccines, and effects of combinations of Gulf War exposures." However, several potential causes of GWI were deemed, "not likely to have caused Gulf War illness for
Gulf War syndrome - Misplaced Pages Continue
4788-589: The Gulf War. After the air war started on January 16, 1991, coalition forces were chronically exposed to low, nonlethal levels of chemical and biological agents released primarily by direct Iraqi attack via missiles , rockets , artillery , or aircraft munitions and by fallout from allied bombings of Iraqi chemical warfare munitions facilities. In 1997, the US Government released an unclassified report that stated: Over 125,000 U.S. troops and 9,000 U.K. troops were exposed to nerve gas and mustard gas when
4902-499: The Institute of Medicine (IOM), part of the U.S. National Academy of Sciences , 250,000 of the 696,842 U.S. servicemen and women in the 1991 Gulf War continue to be affected by chronic multi-symptom illness, which the IOM now refers to as Gulf War illness . The IOM found that it continued to affect these veterans nearly 20 years after the war. According to the IOM, "It is clear that
5016-505: The Iraqi depot in Khamisiyah was destroyed. Studies have confirmed earlier suspicions that exposure to sarin, in combination with other contaminants such as pesticides and PB were related to reports of veteran illness. Estimates range from 100,000 to 300,000 individuals exposed to nerve agents. The 2014 report by the U.S. Department of Veterans Affairs (VA) Research Advisory Committee on Gulf War illnesses (RAC) concluded that, "exposure to
5130-426: The Iraqi dinar, thereby lowering the Kuwaiti currency to one-twelfth of its original value. In response, Sheikh Jaber al-Ahmad al-Sabah ruled the banknotes as invalid and refused to reimburse stolen notes, which became worthless because of a UN embargo. After the conflict ended, many of the stolen banknotes made their way back into circulation. The stolen banknotes are a collectible for numismatists . Kuwaitis founded
5244-517: The Iraqi military struggled against the coalition attacks, Iraq fired missiles at Israel to provoke an Israeli military response, with the expectation that such a response would lead to the withdrawal of several Muslim-majority countries from the coalition. The provocation was unsuccessful; Israel did not retaliate and Iraq continued to remain at odds with most Muslim-majority countries. Iraqi missile barrages against coalition targets in Saudi Arabia were also largely unsuccessful, and on 24 February 1991,
5358-624: The Iraqi point of view that the measures taken by the UAE and Kuwait is, in the final analysis, parallel to military aggression against Iraq, then it would be reasonable for me to be concerned. Saddam stated that he would attempt last-ditch negotiations with the Kuwaitis but Iraq "would not accept death." According to Glaspie's own account, she stated in reference to the precise border between Kuwait and Iraq, "... that she had served in Kuwait 20 years before; 'then, as now, we took no position on these Arab affairs'." Glaspie similarly believed that war
5472-583: The Jeddah talks was an Iraqi demand for $ 10 billion to cover the lost revenues from Rumaila; Kuwait offered $ 500 million. The Iraqi response was to immediately order an invasion, which started on 2 August 1990 with the bombing of Kuwait's capital, Kuwait City . Before the invasion, the Kuwaiti military was believed to have numbered 16,000 men, arranged into three armored, one mechanized infantry and one under-strength artillery brigade. The pre-war strength of
5586-928: The Kansas case definition to the original Kansas study cohort resulted in a prevalence of Gulf War illness of 34.2% in Gulf War veterans and 8.3% in nondeployed Gulf War era veterans, or an excess rate of GWI of 26.3% in Gulf War veterans. Gulf War Coalition: 292 killed (147 killed by enemy action, 145 non-hostile deaths) 776 wounded (467 wounded in action) 31 tanks destroyed/disabled 28 Bradley IFVs destroyed/damaged 1 M113 APC destroyed 2 British Warrior APCs destroyed 1 artillery piece destroyed 75 aircraft destroyed Kuwait: 420 killed 12,000 captured ≈200 tanks destroyed/captured 850+ other armored vehicles destroyed/captured 57 aircraft lost 8 aircraft captured (Mirage F1s) Coalition intervention Naval operations Air campaign Liberation of Kuwait Post-ceasefire The Gulf War
5700-504: The Kuwaiti emir Al Sabah and the Iraqi foreign minister – during which the emir stated his intention to turn "every Iraqi woman into a $ 10 prostitute" by bankrupting the country – was a decisive factor in triggering the Iraqi invasion. On the 25th, Saddam met with April Glaspie , the US Ambassador to Iraq , in Baghdad. The Iraqi leader attacked American policy with regards to Kuwait and
5814-744: The National Academy of Science and the U.S. Department of Defense have used only the term Gulf War illness (GWI). The U.S. Department of Veterans Affairs (VA) confusingly still uses an array of both old and new terminology for Gulf War illness . VA's specialty clinical evaluation War Related Illness and Injury Study Centers (WRIISCs) use the recommended term Gulf War illness , as do VA's Office of Research and Development (VA-ORD) and many recent VA research publications. However, VA's Public Health website still uses Gulf War veterans' medically unexplained illnesses , chronic multi-symptom illness (CMI), and undiagnosed illnesses , but explains that VA doesn't use
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#17329054393605928-519: The Palestinian issue. On 23 August, Saddam appeared on state television with Western hostages to whom he had refused exit visas. In the video, he asks a young British boy, Stuart Lockwood, whether he is getting his milk, and goes on to say, through his interpreter, "We hope your presence as guests here will not be for too long. Your presence here, and in other places, is meant to prevent the scourge of war." Another Iraqi proposal communicated in August 1990
6042-565: The Persian Gulf in response to these threats. Discussions in Jeddah , Saudi Arabia, mediated on the Arab League's behalf by Egyptian President Hosni Mubarak , were held on 31 July and led Mubarak to believe that a peaceful course could be established. During Saddam Hussein's 2003–2004 interrogation following his capture he claimed that in addition to economic disputes, an insulting exchange between
6156-529: The Popular Army. According to John Childs and André Corvisier, a low estimate shows the Iraqi Army capable of fielding 4,500 tanks, 484 combat aircraft and 232 combat helicopters. According to Michael Knights, a high estimate shows the Iraqi Army capable of fielding one million troops and 850,000 reservists, 5,500 tanks, 3,000 artillery pieces, 700 combat aircraft and helicopters; it held 53 divisions, 20 special-forces brigades, and several regional militias, and had
6270-803: The Royal British Legion produced a comprehensive report entitled Legacy of Suspicion , which made recommendations about necessary research and compensation. The Royal British Legion is still campaigning for the UK government to properly address symptoms experienced by veterans of the Gulf War. According to a 2013 report by the Iraq and Afghanistan Veterans of America , veterans of the U.S. wars in Iraq and Afghanistan may also have Gulf War illness, though later findings identified causes that would not have been present in those wars. According to an April 2010 U.S. Department of Veterans Affairs (VA) sponsored study conducted by
6384-506: The Saudi border. After the decisive Iraqi victory, Saddam initially installed a puppet regime known as the " Provisional Government of Free Kuwait " before installing his cousin Ali Hassan al-Majid as Kuwait's governor on 8 August. After the invasion, the Iraqi military looted over $ 1 billion in banknotes from Kuwait's Central Bank. At the same time, Saddam Hussein made the Kuwaiti dinar equal to
6498-467: The U.S. Department of Veterans Affairs found that veterans possibly exposed to chemical warfare agents at Khamisiyah experienced different patterns of brain cancer mortality risk compared to the other groups, with veterans possibly exposed having a higher risk of brain cancer in the time period immediately following the Gulf War. Although an understudied group, opposing Iraqi veterans of the Iraqi Army in
6612-533: The UAE: So what can it mean when America says it will now protect its friends? It can only mean prejudice against Iraq. This stance plus maneuvers and statements which have been made has encouraged the UAE and Kuwait to disregard Iraqi rights ... If you use pressure, we will deploy pressure and force. We know that you can harm us although we do not threaten you. But we too can harm you. Everyone can cause harm according to their ability and their size. We cannot come all
6726-537: The United States 'satisfactory to both nations' national security interests,' develop a joint plan 'to alleviate Iraq's economical and financial problems' and 'jointly work on the stability of the gulf.'" On 29 November 1990, the Security Council passed Resolution 678 , which gave Iraq until 15 January 1991 to withdraw from Kuwait, and empowered states to use "all necessary means" to force Iraq out of Kuwait after
6840-452: The United States had little capability to defend the region. Furthermore, it was determined that a prolonged war in the region would induce much higher oil prices and threaten the fragile recovery of the world economy, which was just beginning to gain momentum. On 22 May 1984, President Reagan was briefed on the project conclusions in the Oval Office by William Flynn Martin who had served as
6954-550: The adoption of UN Security Council Resolution 661 . British prime minister Margaret Thatcher and U.S. president George H. W. Bush deployed troops and equipment into Saudi Arabia and urged other countries to send their own forces. Many countries joined the American-led coalition forming the largest military alliance since World War II . The bulk of the coalition's military power was from the United States , with Saudi Arabia ,
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#17329054393607068-490: The coalition launched a major ground assault into Iraqi-occupied Kuwait. The offensive was a decisive victory for the coalition, who liberated Kuwait and promptly began to advance past the Iraq–Kuwait border into Iraqi territory. A hundred hours after the beginning of the ground campaign, the coalition ceased its advance into Iraq and declared a ceasefire. Aerial and ground combat was confined to Iraq, Kuwait, and areas straddling
7182-571: The coalition states used various names for their operations and the war's operational phases. These are sometimes incorrectly used as the conflict's overall name, especially the US Desert Storm : The US divided the conflict into three major campaigns: Throughout the Cold War , Iraq had been an ally of the Soviet Union , and there was a history of friction between Iraq and the United States. The US
7296-409: The combined effect from one category to the next was significantly greater than the sum of the independent effects of the environmental exposure and the genotype". Although organophosphate pesticides could have triggered the nerve agent alarms in use at the time and contributed to neurotoxic symptoms similar to GWI, Haley et al. ruled out pesticides as a primary cause of GWI, citing that pesticide use
7410-540: The conclusion in the 2008 RACGWVI report that exposures to pesticides and pyridostigmine bromide are causally associated with Gulf War illness. Evidence also continues to demonstrate that Gulf War illness is not the result of psychological stressors during the war." It also found additional evidence since the 2008 report for the role of sarin in GWI, but inadequate evidence regarding exposures to oil well fires, vaccines, and depleted uranium to make new conclusions about them. During
7524-716: The country for economic support – opposed military intervention from non-Arab states. Separately, Sudan, also an Arab League member, aligned itself with Saddam. On 6 August, Resolution 661 placed economic sanctions on Iraq. Resolution 665 followed soon after, which authorized a naval blockade to enforce the sanctions. It said the "use of measures commensurate to the specific circumstances as may be necessary ... to halt all inward and outward maritime shipping in order to inspect and verify their cargoes and destinations and to ensure strict implementation of resolution 661." The US administration had at first been indecisive with an "undertone ... of resignation to
7638-519: The country within two days. The invasion was primarily over disputes regarding Kuwait's alleged slant drilling in Iraq's Rumaila oil field , as well as to cancel Iraq's large debt to Kuwait from the recently ended Iran-Iraq War . After Iraq briefly occupied Kuwait under a rump puppet government known as the Republic of Kuwait , it split Kuwait's sovereign territory into the Saddamiyat al-Mitla' District in
7752-430: The deadline. Recall bias In epidemiological research, recall bias is a systematic error caused by differences in the accuracy or completeness of the recollections retrieved ("recalled") by study participants regarding events or experiences from the past. It is sometimes also referred to as response bias , responder bias or reporting bias . Recall bias is a type of measurement bias , and can be
7866-426: The disease may search their memories more thoroughly than members of the unaffected control group for possible causes of their cancer. Those in the case group (those with breast cancer) may be able to recall a greater number of potential risk factors they had been exposed to than those in the control group (women unaffected by breast cancer). This can potentially exaggerate the relation between a potential risk factor and
7980-408: The disease. To minimize recall bias, some clinical trials have adopted a "wash out period", i.e., a substantial time period that must elapse between the subject's first observation and their subsequent observation of the same event. Use of hospital records rather than patient experience can also help to avoid recall bias. Standardising sampling methods can help to avoid needing recall information in
8094-472: The fact, the committee noted. The report called for a substantial commitment to improving identification and treatment of multisymptom illness in Gulf War veterans focussing on continued monitoring of Gulf War veterans, improved medical care, examination of genetic differences between symptomatic and asymptomatic groups and studies of environment-gene interactions. A variety of signs and symptoms have been associated with GWI: Birth defects have been suggested as
8208-606: The head of the NSC staff that organized the study. (The full declassified presentation can be seen here: ) The conclusions were threefold: first, oil stocks needed to be increased among members of the International Energy Agency and, if necessary, released early if the oil market was disrupted; second, the United States needed to beef up the security of friendly Arab states in the region; and third, an embargo should be placed on sales of military equipment to Iran and Iraq. The plan
8322-491: The hundreds of thousands. Within President Ronald Reagan 's National Security Council concern was growing that the war could spread beyond the boundaries of the two belligerents. A National Security Planning Group meeting was formed, chaired by then Vice President George H. W. Bush , to review US options. It was determined that the conflict would likely spread into Saudi Arabia and other Persian Gulf states, but that
8436-417: The illness are not as clear. Gulf War illness is not the result of combat or other stressors, and Gulf War veterans have lower rates of post-traumatic stress disorder (PTSD) than veterans of other wars. The Royal British Legion said research suggested up to 33,000 UK Gulf War veterans could be living with Gulf War illness, with 1,300 claiming a war pension for conditions connected to their service. In 2007
8550-593: The invasion and demanding a withdrawal of Iraqi troops. On 3 August 1990, the Arab League passed its own resolution, which called for a solution to the conflict from within the league, and warned against outside intervention. Iraq and Libya were the only two Arab League states that opposed the resolution for Iraq to withdraw from Kuwait; the Palestinian Liberation Organization (PLO) opposed it as well. The Arab states of Yemen and Jordan – a Western ally which bordered Iraq and relied on
8664-452: The invasion and even adaptation to it as a fait accompli" until the UK's prime minister Margaret Thatcher played a powerful role, reminding the President that appeasement in the 1930s had led to war, that Saddam would have the whole Gulf at his mercy along with 65 percent of the world's oil supply, and famously urging President Bush "not to go wobbly". Once persuaded, US officials insisted on
8778-518: The majority of ill veterans," including "depleted uranium, anthrax vaccine, fuels, solvents, sand and particulates, infectious diseases, and chemical agent resistant coating (CARC)," for which "there is little evidence supporting an association with Gulf War illness or a major role is unlikely based on what is known about exposure patterns during the Gulf War and more recent deployments." The VA's 2014 RAC report reinforced its 2008 report findings: "The research reviewed in this report supports and reinforces
8892-545: The many physical and psychological issues involved in any war zone deployment, Gulf War veterans were exposed to a unique mix of hazards not previously experienced during wartime. These included pyridostigmine bromide pills (given to protect troops from the effects of nerve agents), depleted uranium munitions, and multiple simultaneous vaccinations including anthrax and botulinum toxin vaccines. The oil and smoke that spewed for months from hundreds of burning oil wells presented another exposure hazard not previously encountered in
9006-620: The medical and scientific establishment. Veterans who continue to suffer from these symptoms deserve the very best that modern science and medicine can offer to speed the development of effective treatments, cures, and—we hope—prevention. Our report suggests a path forward to accomplish this goal, and we believe that through a concerted national effort and rigorous scientific input, answers can be found. Questions still exist regarding why certain veterans showed, and still show, medically unexplained symptoms while others did not, why symptoms are diverse in some and specific in others, and why combat exposure
9120-472: The nerve gas agents sarin/cyclosarin has been linked in two more studies to changes in structural magnetic resonance imaging findings that are associated with cognitive decrements, further supporting the conclusion from evidence reviewed in the 2008 report that exposure to these agents is etiologically important to the central nervous system dysfunction that occurs in some subsets of Gulf War veterans." A 2022 study of 1,016 U.S. Gulf War veterans found evidence of
9234-580: The nerve gas is likely to be responsible for the syndrome. The findings and an editorial by two leading epidemiologists were published in Environmental Health Perspectives . The United States Congress mandated the U.S. Department of Veterans Affairs ' contract with the National Academy of Sciences (NAS) to provide reports on Gulf War illnesses. Between 1998 and 2009, the NAS's Institute of Medicine (IOM) authored ten such reports. In addition to
9348-489: The north, which was absorbed into Iraq's existing Basra Governorate , and the Kuwait Governorate in the south, which became Iraq's 19th governorate. The invasion of Kuwait was met with immediate international condemnation, including the adoption of UN Security Council Resolution 660 , which demanded Iraq's immediate withdrawal from Kuwait, and the imposition of comprehensive international sanctions against Iraq with
9462-545: The opportunity to rebuild your country. But we have no opinion on the Arab-Arab conflicts, like your border disagreement with Kuwait ... Frankly, we can only see that you have deployed massive troops in the south. Normally that would not be any of our business. But when this happens in the context of what you said on your national day, then when we read the details in the two letters of the Foreign Minister, then when we see
9576-467: The region. Iraq also accused Kuwait of exceeding its OPEC quotas for oil production. In order for the cartel to maintain its desired price of $ 18 per barrel, discipline was required. The United Arab Emirates and Kuwait were consistently overproducing; the latter at least in part to repair losses caused by Iranian attacks in the Iran–Iraq War and to pay for the losses of an economic scandal. The result
9690-485: The report recommended the use of two case definitions, the "Kansas" definition and the "Centers for Disease Control and Prevention (CDC)" definition, noting: "There is a set of symptoms (fatigue, pain, neurocognitive ) that are reported in all the studies that have been reviewed. The CDC definition captures those three symptoms; the Kansas definition also captures them, but it also includes the symptoms reported most frequently by Gulf War veterans." The Kansas case definition
9804-431: The same signs and symptoms as those who did deploy, had antibodies to squalene. In contrast, none (0%) of the deployed Persian Gulf veterans not showing signs and symptoms of GWS have antibodies to squalene. Neither patients with idiopathic autoimmune disease nor healthy controls had detectable serum antibodies to squalene." Their work of the researchers was profiled by Gary Matsumoto in "Vaccine A". This research and theory
9918-466: The situation in Kuwait." He also called for a replacement of US troops that mobilized in Saudi Arabia in response to Kuwait's invasion with "an Arab force", as long as that force did not involve Egypt. Additionally, he requested an "immediate freeze of all boycott and siege decisions" and a general normalization of relations with Iraq. From the beginning of the crisis, President Bush was strongly opposed to any "linkage" between Iraq's occupation of Kuwait and
10032-460: The symptoms of Gulf War illness are similar to the symptoms of organophosphate, mustard gas , and nerve gas poisoning. Gulf War veterans were exposed to a number of sources of these compounds, including nerve gas and pesticides . In 2022, researchers led by Robert Haley, MD at University of Texas Southwestern Medical Center found that exposure to sarin nerve gas in soldiers who had a particular genetic mutation that prevented them from breaking down
10146-434: The syndrome were exposed to significant amounts of depleted uranium and that DU "is not and never was in the bodies of those who are ill at sufficient quantities to cause disease". The US military issued pyridostigmine bromide (PB) pills to protect against exposure to nerve gas agents such as sarin and soman . PB was used as a prophylactic against nerve agents; it is not a vaccine. Taken before exposure to nerve agents, PB
10260-528: The term Gulf War syndrome because of varying symptoms. The Veterans Health Administration (VHA) originally classified individuals with related ailments believed to be connected to their service in the Persian Gulf a special non-ICD-9 code DX111, as well as ICD-9 code V65.5. In 1998, the State of Kansas Persian Gulf Veterans Health Initiative sponsored an epidemiological survey led by Dr. Lea Steele of deployment-related symptoms in 2,030 Gulf War veterans. The result
10374-409: The time the ceasefire with Iran was signed in August 1988, Iraq was heavily debt-ridden and tensions within society were rising. Most of its debt was owed to Saudi Arabia and Kuwait. Iraq's debts to Kuwait amounted to $ 14 billion. Iraq pressured both nations to forgive the debts, but they refused. The Iraq–Kuwait border dispute involved Iraqi claims to Kuwaiti territory. Kuwait had been
10488-608: The unexplained illnesses of the Gulf War veterans. The use of organophosphate pesticides and insect repellents during the first Gulf War is credited with keeping rates of pest-borne diseases low. Pesticide use is one of only two exposures consistently identified by Gulf War epidemiologic studies to be significantly associated with Gulf War illness. Multisymptom illness profiles similar to Gulf War illness have been associated with low-level pesticide exposures in other human populations. In addition, Gulf War studies have identified dose-response effects, indicating that greater pesticide use
10602-874: The vaccine led the Committee on Gulf War Veterans' Illnesses to conclude that the vaccine is not a likely cause of Gulf War illness for most ill veterans. However, the committee report does point out that veterans who received a larger number of various vaccines in advance of deployment have shown higher rates of persistent symptoms since the war. However, research was done by PB Asa, Y Cao, and RF Garry on serum antibodies to squalene in Gulf War Syndrome patients. The results showed "the substantial majority (95%) of overtly ill deployed GWS patients had antibodies to squalene. All (100%) GWS patients immunized for service in Desert Shield/Desert Storm who did not deploy, but had
10716-572: The war have consistently indicated that psychiatric illness, combat experience or other deployment-related stressors do not explain Gulf War veterans illnesses in the large majority of ill veterans, according to a U.S. Department of Veterans Affairs (VA) review committee. An April 2010 Institute of Medicine review found, "the excess of unexplained medical symptoms reported by deployed [1991] Gulf war veterans cannot be reliably ascribed to any known psychiatric disorder", although they also concluded that "the constellation of unexplained symptoms associated with
10830-684: The war have consistently indicated that psychiatric illness, combat experience or other deployment-related stressors do not explain Gulf War veterans illnesses in the large majority of ill veterans." The RAC concluded that "exposure to pesticides and/or to PB [pyridostigmine bromide nerve agent protective pills] are causally associated with GWI and the neurological dysfunction in GW veterans. Exposure to sarin and cyclosarin and to oil well fire emissions are also associated with neurologically based health effects. Gene-environment interactions are likely to have contributed to development of GWI in deployed veterans. The health consequences of chemical exposures in
10944-724: The war, by unemployed Iraqis, among them demobilized soldiers. These events drew little notice outside the Arab world because of fast-moving events directly related to the fall of Communism in Eastern Europe. However, the US did begin to condemn Iraq's human rights record, including the well-known use of torture. The UK also condemned the execution of Farzad Bazoft , a journalist working for the British newspaper The Observer . Following Saddam's declaration that "binary chemical weapons" would be used on Israel if it used military force against Iraq, Washington halted part of its funding. A UN mission to
11058-481: The war, many oil wells were set on fire in Kuwait by the retreating Iraqi army, and the smoke from those fires was inhaled by large numbers of soldiers, many of whom had acute pulmonary and other chronic effects, including asthma and bronchitis . However, firefighters who were assigned to the oil well fires and encountered the smoke, but who did not take part in combat, have not had GWI symptoms. The 2008 RAC report states that "evidence [linking oil well fires to GWI]
11172-458: The war. This move was supported by the US, who believed that Iraqi ties with pro-Western Gulf states would help bring and maintain Iraq inside the US' sphere of influence. In 1989, it appeared that Saudi–Iraqi relations , strong during the war, would be maintained. A pact of non-interference and non-aggression was signed between the countries, followed by a Kuwaiti-Iraqi deal for Iraq to supply Kuwait with water for drinking and irrigation, although
11286-399: The way to you in the United States, but individual Arabs may reach you ... We do not place America among the enemies. We place it where we want our friends to be and we try to be friends. But repeated American statements last year made it apparent that America did not regard us as friends. Glaspie replied: I know you need funds. We understand that and our opinion is that you should have
11400-446: Was inversely associated with higher levels of the type Q isozyme , which is more efficient at breaking down sarin than its type R counterpart. The authors "found that the PON1 genotype and hearing nerve agent alarms were independent and the findings robust to both measured and unmeasured confounding , supporting a mechanistic [gene–environment] interaction. ... Moreover, the change in
11514-535: Was "ubiquitous long before the approximately 10,000 alarms began sounding at the start of the air campaign when Coalition bombing of Iraqi chemical weapon facilities released the fallout cloud that reached U.S. troop concentrations just as sarin was detected at multiple sites," while "the PON1 R isoenzyme is the more efficient detoxifier of most pesticides." The Gulf War included the first widespread combat usage of depleted uranium (DU), in tank kinetic energy penetrator and autocannon rounds . DU has been suggested as
11628-495: Was a "clinically based descriptive definition using correlated symptoms" in six symptom groups: fatigue and sleep problems, pain, neurologic and mood, gastrointestinal, respiratory symptoms, and skin (dermatologic) symptoms. To meet the "Kansas" case definition, a veteran of the 1990–91 Gulf War must have symptoms in at least three of the six symptom domains, which during the survey were scored based on severity ("severity"). Symptom onset must have developed during or after deploying to
11742-431: Was a slump in the oil price – as low as $ 10 per barrel ($ 63/m ) – with a resulting loss of $ 7 billion a year to Iraq, equal to its 1989 balance of payments deficit. Resulting revenues struggled to support the government's basic costs, let alone repair Iraq's damaged infrastructure. Jordan and Iraq both looked for more discipline, with little success. The Iraqi government described it as
11856-562: Was an armed conflict between Iraq and a 42-country coalition led by the United States . The coalition's efforts against Iraq were carried out in two key phases: Operation Desert Shield , which marked the military buildup from August 1990 to January 1991; and Operation Desert Storm , which began with the aerial bombing campaign against Iraq on 17 January 1991 and came to a close with the American-led liberation of Kuwait on 28 February 1991. On 2 August 1990, Iraq, governed by Saddam Hussein , invaded neighboring Kuwait and fully occupied
11970-602: Was approved by President Reagan and later affirmed by the G7 leaders headed by the United Kingdom's Prime Minister, Margaret Thatcher , in the London Summit of 1984 . The plan was implemented and became the basis for US preparedness to respond to the Iraqi occupation of Kuwait in 1991. Within hours of the invasion, Kuwait and US delegations requested a meeting of the UN Security Council , which passed Resolution 660 , condemning
12084-526: Was concerned with Iraq's position on Israeli– Palestinian politics. The US also disliked Iraqi support for Palestinian militant groups, which led to Iraq's inclusion on the developing US list of State Sponsors of Terrorism in December 1979. The US remained officially neutral after Iraq's invasion of Iran in 1980, which became the Iran–Iraq War, although it provided resources, political support, and some "non-military" aircraft to Iraq. In March 1982, Iran began
12198-504: Was concluded that while it was unlikely that health effects reported today by Gulf War veterans are the result of exposure solely to PB, use of PB was causally associated with illness. However, a later review by the Institute of Medicine concluded that the evidence was not strong enough to establish a causal relationship. Organophosphate-induced delayed neuropathy (OPIDN, aka organophosphate-induced delayed polyneuropathy) may contribute to
12312-579: Was conducted by commandos deployed by helicopters and boats to attack the city from the sea, while other divisions seized the airports and two airbases . The Iraqis attacked the Dasman Palace , the Royal Residence of Kuwait's Emir , Jaber Al-Ahmad Al-Jaber Al-Sabah , which was defended by the Emiri Guard supported with M-84 tanks. In the process, the Iraqis killed Fahad Al-Ahmed Al-Jaber Al-Sabah ,
12426-634: Was delivered to US National Security Advisor Brent Scowcroft by an unidentified Iraqi official. The official communicated to the White House that Iraq would "withdraw from Kuwait and allow foreigners to leave" provided that the UN lifted sanctions, allowed "guaranteed access to the Persian Gulf through the Kuwaiti islands of Bubiyan and Warbah", and allowed Iraq to "gain full control of the Rumaila oil field that extends slightly into Kuwaiti territory". The proposal also "include[d] offers to negotiate an oil agreement with
12540-410: Was later criticized, and further research has leaned heavily against squalene in vaccinations causing GWS; Perhaps the most important points against this theory include that squalene antibodies have been detected in populations not exposed to squalene containing vaccinations, and that the anthrax vaccines used in the Gulf War did not actually contain squalene in any form. Research studies conducted since
12654-540: Was named Umm al-Ma'arik ("mother of all battles") by Iraqi officials. After the US invasion of Iraq in 2003, the Gulf War of 1990–1991 is often known as the " First Iraq War ". The following names have been used to describe the conflict itself: Gulf War and Persian Gulf War are the most common terms for the conflict used within western countries , though it may also be called the First Gulf War (to distinguish it from
12768-481: Was not imminent. On 26 July 1990, only a few days before the Iraqi invasion, OPEC officials said that Kuwait and the United Arab Emirates had agreed to a proposal to limit their oil output to 1.5 million barrels (240,000 m ) per day, "down from the nearly 2 million barrels a day they had each been pumping," thus potentially settling differences over oil policy between Kuwait and Iraq. The result of
12882-537: Was thought to increase the efficiency of nerve agent antidotes. PB had been used since 1955 for patients who have myasthenia gravis with doses up to 1,500 mg a day, far in excess of the 90 mg given to soldiers, and was considered safe by the FDA at either level for indefinite use and its use to pre-treat nerve agent exposure had recently been approved. Given both the large body of epidemiological data on myasthenia gravis patients and follow-up studies done on veterans it
12996-610: Was to help them succeed in the war against Iran." With Iraq's newfound success in the war, and the Iranian rebuff of a peace offer in July, arms sales to Iraq reached a record spike in 1982. When Iraqi President Saddam Hussein expelled Abu Nidal to Syria at the US's request in November 1983, the Reagan administration sent Donald Rumsfeld to meet Saddam as a special envoy and to cultivate ties. By
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